Recent findings: Pharmacologic therapy remains central to prevent ICD shocks, but there is limited new evidence for drug therapies. Programming techniques continue to evolve which decrease the risk of inappropriate shocks. Cardiac resynchronization therapy (CRT) improves quality of life and decreases mortality, at least in part because of decreased arrhythmia burden. Procedures such as catheter ablation of ventricular tachycardia and procedures to modulate the autonomic nervous system can help minimize ICD therapy.
Summary: Pharmacologic therapy and appropriate device programming remain essential to the overall care of ICD patients. The role of CRT continues to grow as we gain a better understanding of its benefits. Advancements in the fields of catheter ablation and new understanding of the autonomic nervous system's effects on ventricular arrhythmias allow interventions to decrease the frequency of ICD shocks.